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Kidney-Brain Connection May Help Drive Chronic Kidney Disease

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• Salt intake accelerated kidney scarring in rats with chronic kidney disease by activating a brain-kidney connection called the renin-angiotensin axis that interlinks the damaged kidney and brain by afferent and efferent sympathetic nerves. • Targeting these nerves reduced salt-induced kidney scarring.

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High Blood Calcium Levels Linked with Increased Risk of Premature Death in Dialysis Patients

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• Both low and high blood calcium levels, as well as high phosphorus levels, were linked with an increased risk of dying prematurely in dialysis patients, regardless of the type of dialysis. • The findings address a pending Medicare quality measure related to dialysis patients’ blood calcium levels.

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Tool Helps Measure Patients’ Readiness to Make Decisions About Starting Dialysis

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• A new algorithm is a useful tool for measuring chronic kidney disease patients’ readiness for making decisions about initiating dialysis. • Patients who have knowledge about their options and have fewer lifestyle barriers to home dialysis are more likely to be ready to make decisions. Doctors who explain all of the treatment options that are available can increase patients’ readiness for decision-making.

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Study Provides Insights Into the Role of Genetic Variants in Kidney Disease

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• Among patients with a kidney disease called focal segmental glomerulosclerosis (FSGS), those who had certain genetic variants tended to have more advanced disease when they were diagnosed. • Patients with the variants responded to immunosuppressant treatments just as well as other patients but tended to progress more rapidly to kidney failure.

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Kidney Disease on the Rise, but Patients on Dialysis or with Transplant Living Longer

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Fewer new cases of end-stage renal disease are being reported in the United States and mortality rates are declining, indicating that patients on dialysis or with a kidney transplant are living longer.

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Older Kidney Donors with Hypertension May Have Good Kidney Health Following Donation

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Kidney donors with hypertension had slightly fewer nephrons (the kidney’s filtering units) at the time of donation than similarly aged donors with normal blood pressure; however, 6 months following their surgery, hypertensive and non-hypertensive donors both maintained excellent blood pressure control and had similarly robust compensatory kidney responses.

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Taming the Inflammatory Response in Kidney Dialysis

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Frequent kidney dialysis can cause systemic inflammation, leading to complications such as cardiovascular disease and anemia by triggering the complement cascade, part of the innate immune system. Complement is inadvertently activated by modern polymer-based dialysis blood filters. New work has found an effective way to avoid these problems by temporarily suppressing complement during dialysis.

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Drug May Help Prevent Bone Fractures in Patients on Dialysis

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• In patients on dialysis, cinacalcet reduced the rate of bone fracture by 16% to 29%, after accounting for patient characteristics and other factors.

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Low Levels of Circulating Protein Linked with Heart Problems in Mice with Kidney Disease

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• Decreased blood levels of a protein called Klotho increases the risk of heart disease in mice with chronic kidney disease. • If confirmed in humans, increasing Klotho levels may help protect the hearts of patients with chronic kidney disease.